RN to BS Completion Track Application

Notice: You must be admitted to Boise State University prior to completing this form. If you have not applied to Boise State, please submit your Boise State application first.

Have you ever applied to the RN-BS Completion Track before? * Required
- Yes
- No
Contact Information
Name * Required
First Middle Last
Other last names known by
Date of Birth * Required
MM
DD
YYYY
Boise State Student ID * Required
Student ID is provided by Boise State. DO NOT include your social security number in this field.
Mailing Address * Required
We are sorry! Nurses practicing in Louisiana, Georgia, Tennessee and West Virginia are not eligible to enroll in the RN-BS track.

Street Address Address Line 2 City State ZIP Code
Preferred Phone Number * Required
Personal Email Address * Required
Boise State Email Address * Required
Academic Information
Type of Associate Degree * Required
Please be specific. Degree awarded affects course plan. Please check your transcript or diploma for accuracy.
School where you will earn or have earned your associate degree in nursing (ADN) * Required
Date of/or expected Associate Degree in Nursing graduation * Required
MM
DD
YYYY
If you have not graduated from your ADN program, do you plan to concurrently enrol in the RN-BS pre-licensure courses while enrolled in your associate degree program? * Required
- Yes
- No
If yes, when?
MM
DD
YYYY

Please enter an approximate date
Date of first Associate Degree Nursing course * Required
MM
DD
YYYY

Please enter an approximate date
Select the term you anticipate starting the RN-BS Program * Required
Please note the following Deadlines: Spring: November 15 Summer: April 15 Fall: July 15 The term you select here, must match the term you were admitted to Boise State. When selecting the term you wish to start, pay CLOSE ATTENTION to the Term year! E-mail us at rnbs@boisestate.edu with any questions Please contact the School of Nursing before continuing to confirm space availability. Email: rnbs@boisestate.edu
How did you learn about the RN-BS Completion Track? * Required
Who referred you to the RN-BS Completion Track?

We like to thank those who refer students to us.
If known, please provide email or mailing address of the person who referred you so we can thank them
Email Address Street Address City State / Province / Region ZIP / Postal Code Country
Licensure Information
Enter your RN License Number (if pending enter "Pending") * Required

Please only enter your license number or the word Pending. Please do not use N/A or 0.
State where license resides * Required
If you entered PENDING above, enter the state you anticipate being licensed.

State
License Expiration Date
MM
DD
YYYY
If Pending:
I understand that because I am not yet a registered nurse, that my enrollment will be limited to pre-licensure courses.
If pending * Required
- I Agree
If Pending:
I understand that I must pass the NCLEX and submit my RN license number to Boise State before enrolling in any RN-BS courses that require licensure.
If pending * Required
- I Agree
Technology Requirements
I understand that I will need a reliable computer, internet, scan, email including attachments, proficient in MS Word and PowerPoint, access to a device (camera, tablet, smart phone) that allows you to create videos.
I agree to technology requirements * Required
- I Agree
Please review the current technology requirements for online learning.
Employer Information
Current Role or Title * Required
Employer Organization * Required
- St Lukes Regional Medical Center
- Saint Alphonsus Regional Medical Center
- Boise VA
- Unemployed/Full Time Student
Please note: If you work for any affiliation of Idaho St. Lukes system please select St. Lukes Regional Medical Center. Same with Saint Alphonsus and Boise VA. Otherwise, please select "other" and list your employer name.
Photo Release
I hereby grant permission to Boise State University and/or the School of Nursing to photograph me (or my dependent). I understand the photograph(s) taken of me (or my dependent) are the property of the Boise State University and/or School of Nursing and may be used for the advancement and promotion of the University and the School.
I agree to photo release * Required
- I agree
Statements
I have carefully read this application and have answered all questions completely. I declare my answers and all statements made by me therein are true and correct. Should I furnish any false information in this application, I hereby agree that such an act shall constitute cause for denial of admission to and/or dismissal from the Nursing Program at Boise State University.

By checking the "I agree box" within this application, I acknowledge understanding of the following expectations as a self directed learner:

Online Relationships with Faculty/peers
- I will keep my faculty aware of any situations that might impede my participation in or completion of the course.
- I will respond to emails from faculty as soon as possible, preferably within 48 hours during the work week.
- I will willingly participate in group work and uphold group norms set by my peers.
- I will uphold professional communication at all times via email/Skype or phone contacts.
Personal Responsibility
- I will become familiar with the student handbook, syllabus, course assignments, and all due dates at the onset of the course.
- I will establish regular times each week to access my course site, study, read required readings, and complete assignments before due dates to allow for any unexpected changes in family/work plans.
- I will accept the consequences of a lower grade if my participation/or performance falls below course objective expectations.
- I will ask my faculty for assignment clarification in a timely manner before the due dates.
- I understand that plagiarism and cheating does not demonstrate ethical and professional behavior and may be subject to university sanctions.
Licensure Responsibility
- I understand that graduation from the RN-BS program requires an RN License. I understand that prior to passing the NCLEX and becoming a licensed RN that I will be limited to taking courses that designated as pre-licensure.
  See the RN-BS curriculum website for a list of pre-licensure course.
- I agree to expectation statements * Required
  - I Agree
- To Print a copy of this form for your records -- click the Print this Page button.
- Mandatory $20 registration fee. Your application will not be complete until you pay this $20 fee.
  
  Please click continue to be transferred to our secure credit card payment page. Once directed to the payment page, select "RN-BS Application Fee". If you have issues with payment, please email RNBS@BoiseState.edu for a new link. Please do not resubmit your application.
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RN to BS Completion Track Application

Contact Information

Academic Information

Licensure Information

If Pending:

If Pending:

Technology Requirements

Employer Information

Photo Release

Statements

Online Relationships with Faculty/peers

Personal Responsibility

Licensure Responsibility

Section Break

SCHOOL OF NURSING RN-BS